Neuro-Ophthalmology Flashcards

A 14-year-old boy has upgaze palsy, light-near dissociation, eyelid retraction, and convergence-retraction nystagmus. What is the most likely cause?

Answer: Pineal region tumor

Dorsal midbrain (Parinaud) syndrome in a young male is classically caused by a pinealoma compressing the posterior commissure.

Downbeat nystagmus in primary gaze, worse in lateral and downgaze, most commonly localizes to which region?

Answer: Cervicomedullary junction

Downbeat nystagmus classically arises from lesions at the craniocervical junction such as Chiari malformation.

See-saw nystagmus, with one eye elevating and intorting while the other depresses and extorts, is most associated with which lesion?

Answer: Parasellar mass compressing the chiasm

See-saw nystagmus is typically seen with parasellar lesions such as craniopharyngioma, often with bitemporal hemianopia.

An infant has head nodding, torticollis, and fine asymmetric pendular nystagmus. What must be excluded?

Answer: Optic pathway glioma

Spasmus nutans is usually benign, but neuroimaging is needed to exclude chiasmal or hypothalamic glioma that can mimic it.

Applying ice over a ptotic eyelid for 2 minutes produces a 2 mm lid elevation. This supports which diagnosis?

Answer: Myasthenia gravis

Cooling improves neuromuscular transmission by slowing acetylcholinesterase, improving myasthenic ptosis.

A child with otitis media develops ipsilateral abduction deficit and facial pain. What is the syndrome?

Answer: Gradenigo syndrome

Gradenigo syndrome is petrous apicitis causing sixth nerve palsy, trigeminal pain, and otitis.

Ipsilateral optic atrophy with contralateral papilledema and anosmia most suggests which lesion?

Answer: Olfactory groove meningioma

Foster Kennedy syndrome results from a frontal mass compressing one optic nerve while raising intracranial pressure.